Individual provider Active NPI

Jessica Dubois

  • Pharmacist
  • Springfield, MA
National Provider Identifier
1649866716
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH27613 Issued in MA
Practice address
1600 Boston Rd
Springfield, MA 01129-1141
Phone
(413) 543-5428
Fax
(413) 543-0042
NPI assigned
Dec 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH27613 MA Primary

Addresses

Primary practice location

1600 Boston Rd
Springfield, MA 01129-1141

Mailing address

1600 Boston Rd
Springfield, MA 01129-1141
Phone (413) 543-5428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PH27613MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Stop and Shop Supermarket Co LLC PastSince Dec 16, 2020 Accepting new patients
The Stop & Shop Supermarket Company, LLC PastSince Dec 16, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1649866716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 BOSTON RD",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011291141",
            "telephone_number": "413-543-5428",
            "fax_number": "413-543-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 BOSTON RD",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011291141",
            "telephone_number": "413-543-5428",
            "fax_number": "413-543-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH27613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.